Depression Management Program Effective in Long Term

Depression scores, remission rates were better for patients in the program at 18 months

By Jeff Muise

HealthDay Reporter

THURSDAY, Sept. 16 (HealthDay News) -- Chronically depressed patients with persistent symptoms can benefit significantly over the long term from a program of low-intensity depression disease management, according to a study in the September/October issue of the Annals of Family Medicine.

Michael S. Klinkman, M.D., of the University of Michigan Health System in Ann Arbor, and colleagues evaluated the Depression in Primary Care (DPC) intervention, which involved low-intensity depression disease management. The DPC was introduced in five primary care practices in the University of Michigan Health System, while five matched practices were used as controls. The researchers compared Patient Health Questionnaire (PHQ-8) scores and other outcomes for 728 patients enrolled in the DPC program and 78 patients receiving usual care.

Compared to usual-care patients, the investigators found that the mean change in the PHQ-8 score was better for DPC patients at six, 12, and 18 months. Also, the percentage of DPC enrollees in remission at those time points was greater than for the usual-care group: at six months, 43.4 and 33.3 percent, respectively (P = .11); at 12 months, 52.0 and 33.9 percent, respectively (P = .012); and at 18 months, 49.2 and 27.3 percent, respectively (P = .004). After controlling for age, sex, ethnicity, baseline severity, and comorbid medical illness, the researchers confirmed that DPC participants had a significantly greater reduction in depressive symptoms over 18 months.

"The DPC intervention produced sustained improvement in clinical outcomes over 18 months in a cohort of chronically depressed patients with persistent symptoms despite active treatment," the authors write.